Citation Nr: 1040101
Decision Date: 10/26/10 Archive Date: 11/01/10
DOCKET NO. 08-22 133 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Muskogee,
Oklahoma
THE ISSUE
Entitlement to service connection for an acquired psychiatric
disorder, to include posttraumatic stress disorder ("PTSD").
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
T. Y. Hawkins, Associate Counsel
INTRODUCTION
The Veteran served on active duty with the United States Army
from April 1962 to April 1965, and from August 1965 to October
1968.
This matter comes before the Board of Veterans' Appeals
("Board") on appeal from a May 2007 rating decision issued by
the Department of Veterans Affairs ("VA") Regional Office
("RO") in Muskogee, Oklahoma, which denied the Veteran's claim
of entitlement to service connection for PTSD.
In May 2010, the Veteran testified at a video conference hearing
before the undersigned Veterans Law Judge sitting in Washington,
DC. A transcript of this proceeding has been associated with the
claims folder.
The record reflects that the Veteran has submitted additional
evidence to the Board in conjunction with this case, accompanied
by a waiver of initial review of the evidence by the agency of
original jurisdiction in accord with 38 C.F.R. § 20.1304 (2010).
FINDINGS OF FACT
1. The Veteran did not serve in combat, and his alleged in-
service stressors are not consistent with the places, types and
circumstances of his military service.
2. A valid diagnosis of PTSD based upon a verified stressor is
not of record, nor is any other acquired psychiatric disorder
shown to be the result of military service.
CONCLUSION OF LAW
Service connection for an acquired psychiatric disorder, to
include PTSD, is not warranted. 38 U.S.C.A. §§ 1110, 5103,
5103A, 5107 (West 2002 & Supp. 2010); 38 C.F.R. §§ 3.159, 3.303,
3.304(f) (2010).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
I. Veterans Claims Assistance Act of 2000 ("VCAA")
With respect to the Veteran's claim, VA has met all statutory and
regulatory notice and duty to assist provisions. See 38 U.S.C.A.
§§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002 & Supp.
2010); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2010).
a.) Duty to Notify
Under the VCAA, when VA receives a complete or substantially
complete application for benefits, it is required to notify the
claimant and his or her representative, if any, of any
information and medical or lay evidence that is necessary to
substantiate the claim. 38 U.S.C.A. § 5103(a) (West 2002); 38
C.F.R. § 3.159(b) (2010); Quartuccio v. Principi, 16 Vet. App.
183 (2002). In Pelegrini v. Principi, 18 Vet. App. 112, 120-21
(2004) ("Pelegrini II"), the United States Court of Appeals for
Veterans Claims ("Court") held that VA must inform the claimant
of any information and evidence not of record (1) that is
necessary to substantiate the claim; (2) that VA will seek to
provide; (3) that the claimant is expected to provide; and (4)
request that the claimant provide any evidence in his or her
possession that pertains to the claim. Element (4), the
requirement of requesting that the claimant provide any evidence
in his possession that pertains to the claim, was eliminated by
the Secretary during the course of this appeal. See 73 Fed. Reg.
23353 (final rule eliminating fourth element notice as required
under Pelegrini, effective May 30, 2008).
The VCAA notice requirements apply to all five elements of a
service connection claim. These are: (1) veteran status; (2)
existence of a disability; (3) a connection between a veteran's
service and the disability; (4) degree of disability; and (5)
effective date of the disability. See Dingess/Hartman v.
Nicholson, 19 Vet. App. 473 (2006), aff'd, Hartman v. Nicholson,
483 F.3d 1311 (Fed. Cir. 2007). Of particular importance, in
Dingess/Hartman, the Court held that the VCAA notice must include
notice that a disability rating and an effective date of the
award of benefits will be assigned if service connection is
awarded.
In this case, VA essentially satisfied the notification
requirements of the VCAA by means of a letter dated October 2006.
The RO informed the appellant of the types of evidence needed in
order to substantiate his claim of entitlement to service
connection and of the division of responsibility between the
appellant and VA for obtaining the required evidence. The RO
also requested that the appellant provide any information or
evidence in his possession that pertained to such claim.
38 U.S.C.A. §5103(a); 38 C.F.R. § 3.159(b). In addition, the
letter satisfied the requirements of Dingess and informed the
Veteran of how VA determines the disability rating and effective
date elements of a claim.
b.) Duty to Assist
The Board is satisfied that the duty to assist has been
satisfied. The claims folder contains the Veteran's service
treatment and personnel records, as well as his post-service VA
Medical Center ("VAMC") treatment records. The claims file
also contains the Veteran's statements in support of his claim.
The Veteran has not referenced any outstanding, available records
that he wanted VA to obtain or that he felt were relevant to the
claim that have not already been obtained and associated with the
record.
The Board notes that in the case of McLendon v. Nicholson, 20
Vet. App. 79 (2006), the Court held that an examination is
required when (1) there is evidence of a current disability, (2)
evidence establishing an "in-service event, injury or disease,"
or a disease manifested in accordance with presumptive service
connection regulations occurred which would support incurrence or
aggravation, (3) an indication that the current disability may be
related to the in-service event, and (4) insufficient evidence to
decide the case.
The Board has determined that VA had no duty to provide a VA
medical examination or opinion with respect to the Veteran's
claim. In this regard, the Board observes that, although the
record reflects that the Veteran was diagnosed with PTSD by a
third-year medical student at the VAMC, as will be discussed in
greater detail below, the claims folder contains no evidence that
he served in combat during active military service, and his
claimed stressors are not consistent with the places, types and
circumstances of his active duty service. Thus, in the absence
of such evidence, there is no reasonable possibility that a VA
examination would result in findings favorable to the Veteran;
service connection therefore cannot be established for the
claimed disability. Accordingly, the Board finds that an medical
opinion is not necessary. See generally Wells v. Principi, 326
F.3d 1381 (Fed. Cir. 2003).
In addition, the Board concludes that all reasonable efforts to
develop evidence for the record have been made. In October 2006,
the Veteran's reported stressors were provided to the U.S. Army
and Joint Services Records Research Center ("JSRRC")
coordinator. In March 2007, the coordinator responded that the
Veteran's claimed stressors could not be verified. Subsequently,
the RO sent a letter to the Veteran requesting more specific
information to allow for an attempt to verify his claims; the
Veteran, however, failed to respond. In May 2007, the JSRRC
coordinator issued a "Formal Finding" memorandum, in which it
determined that the information required to allow the JSRCC to
corroborate the stressful events described by the Veteran was
insufficient.
In April 2008, after receiving the Veteran's complete service
personnel records, the JSRCC coordinator concluded that his
personnel records failed to show that he was assigned or attached
to the places in Vietnam that he claimed in his stressor
statements, and that, more importantly, he was not in Vietnam at
the time he initially claimed to have been. The JSRRC
coordinator specifically noted that, while the Veteran claimed to
have served as part of the I Corps Tactical Zone ("CTZ") in the
northernmost part of South Vietnam, his service personnel records
showed that he actually served with the III CTZ, located in the
southern part of South Vietnam, near Saigon, hundreds of miles
away from the I CTZ. The coordinator also observed that the
Veteran did not arrive in Vietnam until January 1968, thus his
claims of having provided support to the Marines at Khe Sanh in
October 1967 in the I CTZ were unfounded. In July 2009, the
JSRCC coordinator again issued a "Formal Finding" memorandum,
in which it found that the additional information provided by the
Veteran was still insufficient to allow for the JSRCC to
corroborate the stressful events he reported. He further noted
that all procedures to obtain this information had been properly
followed, all efforts to obtain such information had been
exhausted, and concluded that any further attempts would be
futile. The Veteran subsequently submitted an additional
stressor statement, in which he claimed that he had erroneously
provided incorrect information regarding his assigned locations
and dates, and now alleged that the claimed stressors actually
occurred in 1968 at different locations, including those that
were listed in his personnel records. Following a September 2009
letter from the RO to the Veteran requesting more specific
details concerning his claimed stressors, the Veteran failed to
respond.
In light of the requests for information sent by the RO to the
Veteran, the personnel records showing that he did not arrive in
Vietnam until January 1968, that he did not serve with the
Marines in the I CTZ, and the lack of sufficient detail regarding
his stressors that would allow for corroboration of the claimed
events, the Board finds no basis for further pursuit of
verification. 38 C.F.R. § 3.159(c)(2) and (3). In essence, no
further notice or assistance is required to fulfill VA's duty to
assist the appellant in the development of the claim. Smith v.
Gober, 14 Vet. App. 227 (2000), aff'd, 281 F.3d 1384 (Fed. Cir.
2002); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); see also
Quartuccio v. Principi, 16 Vet. App. 183 (2002).
In short, the Board has carefully considered the provisions of
the VCAA in light of the record on appeal, and for the reasons
expressed above, finds that the development of the claim has been
consistent with the provisions of the VCAA. The appellant has
been provided with every opportunity to submit evidence and
argument in support of his claim, and to respond to the VCAA
notice. The purpose behind the notice requirement has been
satisfied because the appellant has been afforded a meaningful
opportunity to participate effectively in the processing of his
appealed claim.
II. Analysis
The Board must assess the credibility and weight of all evidence,
including the medical evidence, to determine its probative value,
accounting for evidence which it finds to be persuasive or
unpersuasive, and providing reasons for rejecting any evidence
favorable to the claimant. Equal weight is not accorded to each
piece of evidence contained in the record; every item of evidence
does not have the same probative value. When all the evidence is
assembled, VA is responsible for determining whether the evidence
supports the claims or is in relative equipoise, with the Veteran
prevailing in either event, or whether a preponderance of the
evidence is against the claims, in which case, the claims are
denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990).
The Board has thoroughly reviewed all the evidence in the
Veteran's claims folder. Although the Board has an obligation to
provide reasons and bases supporting this decision, there is no
need to discuss, in detail, the evidence submitted by the Veteran
or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81
(Fed. Cir. 2000) (the Board must review the entire record, but
does not have to discuss each piece of evidence). The analysis
below focuses on the most salient and relevant evidence and on
what this evidence shows, or fails to show, on the claims. The
Veteran must not assume that the Board has overlooked pieces of
evidence that are not explicitly discussed herein. See
Timberlake v. Gober, 14 Vet. App. 122 (2000) (the law requires
only that the Board address its reasons for rejecting evidence
favorable to the Veteran).
Under 38 U.S.C.A. § 1154(a), VA is also required to give "due
consideration" to "all pertinent medical and lay evidence" in
evaluating a claim for disability or death benefits. In Jandreau
v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007), the United
States Court of Appeals for the Federal Circuit ("Federal
Circuit") held that "[l]ay evidence can be competent and
sufficient to establish a diagnosis of a condition when (1) a
layperson is competent to identify the medical condition, (2) the
layperson is reporting a contemporaneous medical diagnosis, or
(3), lay testimony describing symptoms at the time supports a
later diagnosis by a medical professional." (footnote omitted).
However, the Court has held that "[t]he type of evidence that
will suffice to demonstrate entitlement to service connection,
and the determination of whether lay evidence may be competent to
satisfy any necessary evidentiary hurdles, depends on the type of
disability claimed." Barr v. Nicholson, 21 Vet. App. 303, 308
(2007).
In order to establish a right to compensation for a present
disability, a veteran must show: "(1) the existence of a
present disability; (2) the in-service incurrence or aggravation
of a disease or injury; and (3) a causal relationship between the
present disability and the disease or injury incurred or
aggravated during service"- the so-called "nexus"
requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir.
2004).
Alternatively, under 38 C.F.R. § 3.303(b), service connection may
be awarded for a "chronic" condition when (1) a chronic disease
manifests itself and is identified as such in service, or within
the presumptive period under 38 C.F.R. § 3.307, and the veteran
presently has the same condition; or (2) a disease manifests
itself during service, or during the presumptive period, but is
not identified until later, and there is a showing of continuity
of related symptomatology after discharge, and medical evidence
relates that symptomatology to the Veteran's present condition.
Savage v. Gober, 10 Vet. App. 488, 495-98 (1997).
Service connection for PTSD specifically requires (1) medical
evidence establishing a diagnosis of the disability, (2) credible
supporting evidence that the claimed in-service stressor
occurred, and (3) a link, established by medical evidence,
between the current symptomatology and the claimed in-service
stressor. See 38 C.F.R. § 3.304(f) (2009). See also Cohen v.
Brown, 10 Vet. App. 128 (1997).
If the evidence establishes that the veteran engaged in combat
with the enemy and the claimed stressor is related to that
combat, in the absence of clear and convincing evidence to the
contrary, and provided that the claimed stressor is consistent
with the circumstances, conditions, or hardships of the veteran's
service, the veteran's lay testimony alone may establish the
occurrence of the claimed in-service stressor. See 38 C.F.R. §
3.304(f)(1); see also, 38 U.S.C.A. § 1154(b) (West 2002 & Supp.
2010). Otherwise, the law requires verification of a claimed
stressor. 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d), (f);
Gaines v. West, 11 Vet. App. 353, 357-58 (1998).
In his first stressor statement, the Veteran claimed that he
served in Vietnam from September or October 1967 to October 1968
as a truck driver. He said that he began by serving with the
537th Transportation Company in Long Binh (located near Saigon in
the southern part of South Vietnam, in the III CTZ), then was
sent to Dong Ha (in the I CTZ, the northernmost part of South
Vietnam, near Khe Sanh,) for four months, and then drove back to
Long Binh. He said that his stressor occurred in October 1967,
when he was assigned to support the Marines serving in Khe Sanh.
He specifically noted that the Marines had been pinned down at
that location by the enemy for 77 days. He said that, while
driving just outside of Khe Sahn to deliver fuel and supplies,
the motor pool came under heavy rocket and mortar attack, with
rockets exploding all around him. He said that he was forced to
leave his truck and run for cover, which put him in fear for his
life.
As discussed above, the RO sent the Veteran's statements to the
JSRCC coordinator, who noted that his service personnel records
failed to support his claims of having been assigned or attached
to Dong Ha, of having supported the Marines at Khe Sanh in the I
CTZ, or having been in country in 1967. Rather, it was noted
that these reports showed that he did not arrive in Vietnam until
January 1968, where he was assigned to the 538th and 47th
Transportation Companies in III CTZ in Long Binh, the III CTZ
headquarters. Moreover, it was noted that his DD-Form 214 showed
that he did not receive any decorations, medals or citations that
would verify his participation in combat.
In February 2009, after having been notified that his claimed
stressor statement did not correspond with his service personnel
reports, the Veteran submitted a revised stressor statement, in
which he claimed that several soldiers got killed during the
rocket and mortar attacks and that he had seen the bodies of
several soldiers that he knew. After it was determined that this
information was still insufficient to allow for verification of
his claimed stressors, in August 2009, the Veteran submitted
third stressor statement, in which he claimed to have served in
the places that were listed in his service personnel records. He
also said that he had previously provided incorrect information,
and admitted that he did not actually arrive in Vietnam until
1968.
As such, although the Veteran claimed to have served in locations
that exposed him to various combat-related stressors, the RO
denied his claim because, under the former provisions of
38 C.F.R. § 304(f), there was no proof of combat service, and the
Veteran was therefore required to provide credible supporting
evidence that the claimed in-service stressor(s) had occurred.
The provisions of 38 C.F.R. § 3.304(f) were recently amended,
however, effective July 13, 2010, during the pendency of this
appeal. See 75 Fed. Reg. 39843-52 (July 13, 2010). The primary
effect of the amendment, which relaxes the evidentiary standard
for establishing in-service stressors in PTSD claims, is the
elimination of the requirement for corroborating evidence of the
claimed in-service stressor(s) if it is related to the veteran's
"fear of hostile military or terrorist activity." In place of
corroborating the reported stressor(s), VA will now rely on a
veteran's lay testimony alone to establish the occurrence of a
stressor related to hostile military or terrorist activity,
provided that (1) the claimed stressor is consistent with the
places, types and circumstances of service (in the absence of
clear and convincing evidence to the contrary), (2) a VA
psychiatrist or psychologist, or a psychiatrist or psychologist
with whom VA has contracted, confirms that the claimed stressor
is adequate to support a diagnosis of PTSD, and (3) the veteran's
PTSD symptoms have been medically-related to the in-service
stressor by a VA psychiatrist or psychologist, or a psychiatrist
or psychologist with whom VA has contracted.
For the purpose of this regulation, "fear of hostile military of
terrorist activity" means that a veteran experienced, witnessed,
or was confronted with an event or circumstance that involved
actual or threatened death or serious injury, or a threat to the
physical integrity of the veteran or others, such as from an
actual or potential improvised explosive device (IED); vehicle-
imbedded explosive device; incoming artillery, rocket or mortar
fire; grenade; small arms fire, including suspected sniper fire;
or attack upon friendly military aircraft, and the veteran's
response to the event or circumstance involved a psychological or
psycho-physiological state of fear, helplessness, or horror.
38 C.F.R. § 3.304(f).
A review of the claims folder reveals that the Veteran was
initially evaluated for PTSD in April 2005 at the VAMC. During
an evaluation by a VA clinical psychologist, the Veteran said
that he was continuing to have problems with substance abuse;
however, he made no mention whatsoever of any stressors related
to his Vietnam service. The VA clinical psychologist diagnosed
him on Axis I with (1) a mood disorder: cocaine-induced
depressive disorder, and (2) addictive disorder: cocaine abuse.
However, the psychologist specifically ruled out a diagnosis of
PTSD.
Four months later, in August 2005, the Veteran was examined at
the VAMC pursuant to his participation in the VA PTSD recovery
program. The examining clinician was a third-year medical
student. At that time, the Veteran said that while driving
convoy vehicles in Vietnam, he was afraid of getting ambushed or
bombed by the enemy. However, he also said that he continued to
be angry with his ex-wife due to an incident that had occurred in
the early 1970's, when she stabbed him with a knife shortly after
his return from Vietnam. He told the examiner that he
experienced anger whenever he thought about how he could have
been killed by the bombings in Vietnam or by his wife. Based on
these statements, the Veteran was diagnosed on Axis I with PTSD
and polysubstance abuse in remission. However, as noted above,
the examiner was neither a VA psychiatrist or psychologist, nor a
psychiatrist or psychologist who had a contract for services with
VA. The Board also notes that, although the examination report
was co-signed by a VA medical doctor, there is no indication that
she herself was a psychiatrist. Moreover, based on the fact that
the Veteran claimed to have PTSD symptomatology based on an in-
service stressor and a non-service-related personal assault by
his former wife, it is not clear whether the examiner
specifically related his symptoms only to his claimed in-service
stressors.
Finally, the Board also notes that a review of the examination
report reveals that the medical student's PTSD evaluation and
diagnosis does not appear to have met the criteria of the
American Psychiatric Association: Diagnostic and Statistical
Manual of Mental Disorders (4th ed. 1994) ("DSM-IV").
According to the DSM-IV, diagnostic criteria for PTSD include a
history of exposure to a traumatic event meeting two criteria,
and symptoms from each of the following three symptom clusters:
intrusive recollections, avoidant/numbing symptoms, and
hyperarousal symptoms. A fifth criterion concerns duration of
symptoms, and a sixth assesses functioning. Based on the August
2005 examination report, it does not appear that the examiner
considered anything more than the Veteran's claim of having been
exposed to a traumatic event (either the service or non-service
stressor), without any mention or discussion of whether he
experienced avoidant/numbing symptoms, intrusive recollections or
hyperarousal symptoms. Accordingly, the Board concludes that a
valid diagnosis of PTSD based upon a verified stressor or
stressors is not of record.
III. Conclusion
It is the responsibility of the Board to weigh the evidence,
including the medical evidence, to determine where to give credit
and where to withhold the same, and in so doing, the Board may
accept one medical opinion and reject others. Evans v. West, 12
Vet. App. 22, 30 (1998), citing Owens v. Brown, 7 Vet. App. 429,
433 (1995). The Board is mindful that it cannot make its own
independent medical determinations, and that it must have
plausible reasons, based upon medical evidence in the record, for
favoring one medical opinion over another. Evans v. West; see
also Rucker v. Brown, 10 Vet. App. 67, 74 (1997), citing Colvin
v. Derwinski, 1 Vet. App. 171 (1991). Thus, the weight to be
accorded the various items of evidence in this case must be
determined by the quality of the evidence, and not necessarily by
its quantity or source.
Based on a review of the complete evidence of record, the Board
concludes that a preponderance of the probative evidence is
against the Veteran's claim of entitlement to service connection
for an acquired psychiatric disorder, to include PTSD.
In this regard, the Board finds the most probative evidence to be
the April 2005 examination report from the VA psychologist, who
opined that the Veteran did not have PTSD, but rather, had a mood
and an addictive disorder. Interesting, although the Veteran now
claims that he had struggled with PTSD symptomatology ever since
service, when he had an opportunity to discuss his in-service
stressor with a psychologist, he did not do so, and instead,
spoke only about his problems with substance abuse. No acquired
psychiatric disorder was related by the VA examiner to the
Veteran's military service.
In addition, the Board concludes that the Veteran's assertions
regarding his claimed Vietnam stressors are simply not credible.
As noted above, when the Veteran initially applied for service
connection for PTSD, he stated that he had arrived in Vietnam in
September or October 1967 and had been present with the Marines
in Khe Sanh in the I CTZ. He also provided a very vague
statement of having been afraid due to coming under attack by
enemy fire. However, when told that these events could not be
substantiated and asked to provide more specific information
regarding the names of individuals with which he served, as well
as the approximate dates he came under fire, he was unable to do
so. Thereafter, when he was informed that his claimed in-country
dates and locations did not match the information in his service
personnel records, the Veteran changed his story and said that he
was mistaken about having been in Vietnam in October 1967, and
did not arrive until 1968. He also reported that, instead of
being in the I CTX, he was actually in the III CTZ , as listed in
his personnel reports. Based on his inconsistent statements
regarding his dates and locations in Vietnam, the Board also
concludes that his claimed PTSD symptomatology is not credible.
In this respect, the Board has taken into consideration the new
regulations of 38 C.F.R. § 3.304(f), which state that, provided
the claimed stressor is consistent with the places, types and
circumstances of his service, the veteran's lay testimony alone
may establish the occurrence of the claimed in-service
stressor(s). Id. However, because the question of whether a
veteran was exposed to a stressor in service is a factual one, VA
adjudicators are not bound to accept medical opinions based upon
uncorroborated accounts of stressors. Wood v. Derwinski, 1 Vet.
App. 190, 192 (1991), aff'd on reconsideration, 1 Vet. App. 406
(1991). In this case, even assuming that the VA medical
student's examination satisfied the criteria of the DSM-IV for a
diagnosis of PTSD, based on the findings by the JSRCC coordinator
and the RO that the Veteran's claims concerning his locations and
duties in Vietnam did not correspond to the verifiable facts as
shown in his service personnel records, as well as the fact that,
when informed of these findings, the Veteran abruptly changed his
stressor statement to more closely match his service personnel
records, the fact remains that the Board deems the Veteran's
contentions regarding his experiences in service to be
untruthful. As such, the Board finds that his claimed stressors
are not consistent with the places, types and circumstances of
his service, and therefore, his lay statements alone are
insufficient to establish the occurrence of his claimed in-
service stressors.
Additionally, the Board notes that the threshold requirement for
service connection to be granted is competent medical evidence of
the current existence of a claimed disorder. See Degmetich v.
Brown, 104 F.3d 1328 (1997); Brammer v. Derwinski, 3 Vet. App.
223 (1992). Thus, without a current diagnosis of PTSD, in
addition to the fact that there is no credible supporting
evidence that the claimed in-service stressors actually occurred
because of the inconsistent statements made by the Veteran, here
may be no service connection for the claimed disorder. No other
acquired psychiatric disorder is shown to have been incurred in
or aggravated by military service.
In summary, and for the reasons stated above, the Board finds
that the preponderance of the evidence is against the Veteran's
claim of entitlement to service connection for an acquired
psychiatric disorder, to include PTSD. As there is not an
approximate balance of evidence, the "benefit of the doubt"
rule is not for application. See Gilbert v. Derwinski, 1 Vet.
App. 49 (1990); Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir.
2001).
(CONTINUED ON NEXT PAGE)
ORDER
Entitlement to service connection for an acquired psychiatric
disorder, to include PTSD, is denied.
____________________________________________
BARBARA B. COPELAND
Veterans Law Judge, Board of Veterans' Appeals
Department of Veterans Affairs